The social worker contacted me today and said my Mom will need to be discharged by Monday due to non payment of Medicare. Her first post op visit was yesterday and the immobilizer came off and sutures were removed, healing is going well in that regard. A new order was given for PT for weight bearing. Now they think she can be safely discharged home after one morning of PT without the brace? Last night when I visited her she was using a wheelchair to go to the bathroom. Now today they think she can go home and hobble around back and forth to the kitchen and bathroom when she has been non weight bearing for weeks? This is her third leg surgery since October and I fear if she goes home, she will not be strong enough to get around quite yet. The social worker then said she can file an appeal. My mom said she is not filing an appeal and she is going home since the insurance is not paying for it. There is NO explaining to her that the appeal can be filed and she can stay there for a few more weeks to give herself time to gain strength. She called everyone to come and get her tonight. I don't know what is happening but the social worker seemed like she was encouraging my mom to go home. My mom understood the need to stay when we saw the Dr yesterday. But now today after the social worker said her insurance wouldn't pay, she wants out of there. I told the social worker that she needs to be able to safely go home with necessary equipment, wheelchair, shower bench, raised toilet seat. Any other suggestions? Again, I am not her POA but how can they discharge her so soon going home alone?
Look, YOU are not going to convince your mom of anything. She's mentally ill, won't give anyone POA and has zero insight into her limitations. And she manipulates you through Fear, Obligation and Guilt.
It is not possible for you to determine what she actually needs and what is manipulation. Much better to allow someone else to take this on, or step away so that she fails and ends up back in the hospital.
That sounds cruel, I know. But sometimes it's the only way to get an intansigent elder the help they need.
Mom was not independent BEFORE this incident, right? Insist on an assessment of the home.
The appeal will have to be filed.
On Jan 3, you wrote: >>Now she said if "you can't" go with me then I'll go by myself. She would never make it to the Dr appointment by herself. The hospital is huge. She is non weight bearing on the surgical leg. She has transportation to the hospital but they aren't responsible for taking her to the 23rd floor for her appointment. and then she will tell my sister how awful I am for not going with her. Just like she told her how awful I am for putting her in a "nursing home". >>
So did you take her to the dr. appt on the 23rd floor? Sounds like you probably did. Also sounds like you are concerned what your mother tells your sister about you.
Also sounds like this rehab wants her out, partially because of her abuse allegations. And if she won't consider an appeal, she will be out. And I'm sure she is telling them that YOU are the plan.
So what is going to happen? Instead of being so focused on "they shouldn't do that!" how about some more focus on what will happen if they do release her. What will be your part in all of that?
Will you take her home? Will you agree to get her the necessary medical supplies? Hire all the help? Be there when help isn't, or when help doesn't show up? I know you do NOT want to do this. But do you feel as if you will have to?
Let us know YOUR plans. What are YOUR boundaries? Remember than anything couched in "temporary" terms often becomes permanent.
Regarding the facility, I very clearly told the social worker, the facility liaison, and the nurse manager I work a full time job and I am unable to help her 24/7 therefore they need to ensure she is safe to go home alone. I reminded them that she is now on a new psychiatric medication and she will need to follow up with a higher level of care for her diagnosis of severe depression as her former psychiatrist was only treating her over a phone call. I personally think she needs outpatient visits due to her ongoing mental health history.
my mom called my husband last night and told him that I filed an appeal to keep her there. My husband explained that is not how it works as I cannot do anything because I am not her POA. They (care team) calls me because I've been involved as giving collateral information to help guide them with her care. She also told my husband she is getting a lawyer and suing me because I lied about her and I also impersonated as her to her insurance company to keep her there.
Then she said, "THEY told me how you would be when it comes to this" (THEY: likely meaning my sister who initially said I was awful for wanting "put her in a nursing home (i.e, rehab) after her first surgery before she went home and ended up in a psychiatric unit. So, I told the social, it's clear she does not think I have helped her, I am not looking out for her well-being, and I am lying. So why am I being called? I told her I had to get back to work. Mom told my husband and daughters she will never speak to me again and that I lied on her. I explained to the facility care team how she presented at home before this last admission to the psychiatric unit. SHE WAS NOT WELL. I did not lie but in her mind, she doesn't recall all details of what happened. She was in a very serious state of depression with psychosis.
Mom continued to call both of my daughters and my husband to come get her last night. Husband was at work, daughters called me asking what they should do. Of course they didn't get her but this will be her next plan. To try and get them to help her. Again, while my sister works a part time cashier job a 1000 miles away and is no help.
It sounds to me as though your Mom isn't ready to be at home on her own. Your sister doesn't agree. At some point, your realizing that this cannot work is going to mean that you may need to step away from enabling it. You may need not to attempt to take the place of a system of care that you are unable to replace. You may need to tell both Mom and Sis that you are out of this. If Mom and the system think she is fine at home, that's great. Give her the 911 number to call when she is NOT fine. Outfit her with the necklace alarm so she can contact ambulance services. Enough admissions and they will treat her as they would treat someone without family; they will place her until she is well enough (if ever) to be home.
Beatty on Forum has an expression that goes "There will be no solution as long as YOU are all of the solutions". It is so true.
So sorry for all you are going through.
But do know, the appeal should be filed. The doctor needs to say this is needed care. And do not go to get her. That is agreeing to and enabling this unsafe discharge. Make it clear to the Social Worker Mom will be alone and this is an unsafe discharge. Demand that this go into Mom's chart. Let them know that YOU are not the answer to their not providing care. They will says she needs placement at that point. They are correct. She does. But if you enable all of this, it won't happen and you will soon enough be back at square one.